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Shingles
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Shingles is a painful blistering rash caused by reactivation of varicella, the chickenpox virus. It is also known as Herpes zoster. It occurs only in people who have had chicken pox in the part.

It is very surprising to know that the virus reactivates in some individuals while in others it is not reactivated but the reason for this is not known. This disease is mainly seen in the elderly but in some cases it occurs in younger individuals. It is seen commonly in both males and females and all races are equally affected. It commonly occurs sporadically throughout the year.

Causes of Shingles

Chickenpox or Varicell is the primary infection with the virus, Herpes zoster, also called as “Varicella-zoster. During this widespread infection, which occurs mainly in childhood the virus is seeded to nerve cells in the spinal cord that is usually the nerves, which supply sensation to the skin.

The virus generally remains in a resting phase in these nerves cells for years before it is reactivated and grows down the nerves to the skin to produce shingles or zoster. This can occur in childhood but in much more common in adults, especially the elderly. It is not clear why shingles affects a particular nerve fibre.

It may be set off by pressure on the nerve roots, by radiotherapy at the level of the affected nerve, root, by spinal surgery, by an infection such as sinusitis or by an injury, not necessarily to the spine. Shingle is more severe and common in patients with poor immunity. Blisters can occur in more than one area and the virus may affect internal organs, such as gastrointestinal tract, the lungs and the brain.

Shingles in the early months of pregnancy can harm the fetus, but this condition is very rare. The fetus may be infected by chickenpox in later pregnancy and then develop shingles as an infant. A person must have already had chickenpox in the past to develop shingles. Contact with an infected individual does not cause another person’s dormant virus to reactivate. However, the virus from a shingles patient may cause chickenpox in someone who has not had it before.

Symptoms of Shingles

The first sign of shingles is generally is tingling feeling on the skin, itchiness or a stabbing pain. After several days, a rash appears beginning as a band or patch of raised dots on the side of the trunk or face. It then develops into small, fluid filled blisters, which begin to dry out and crust over within a few days. When the rash is at its peak, symptoms can range from milk itching to extreme and intense pain. The rash and pain usuallydisappear within three to five weeks.

Treatment of Shingles

Person having shingles should see the doctor as soon as possible. Antiviral treatment can reduce pain and the duration of symptoms. Rest and pain relief are important, hence person should try paracetamol initially. Antiviral medications available for shingles are the like Acyclovir, Valaciclovir and Famciclovir.

Capsaicin cream may be helpful for pain relief for post-herpetic neuralgia. A bland, protective application should be applied to the rash. Person should try povidine iodine or calamine lotion. In severe cases, acyclovir may be given intravenously for few-days. In some circumstances, systemic steroids may also be used.



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